12/2018 cmc DNR Form 542-3115 Watch our 2 new videos on “How to Report Your Water Use” www.iowadnr.gov/wateruse/ Instructions to fill out form and report your annual Water Usage WATER USE PERMIT # Annual Water Usage Source: Consider creating an account at https://programs.iowadnr.gov/wateruse/ where you may renew your permit, apply for a new permit, manage it, pay any applicable fees, and report, all online. Questions? Call 515-725-3407 or email [email protected] Report by Source. Well data: the chart below must be completed for all Groundwater Sources. Local Well Name Static Water Level (feet bgs) Hours Idle Before Measurement Pumped Water Level (feet bgs) Hours Pumped Pumping Rate (gpm) Date Measured Unable to take accurate water level measurements (add pages if needed) This is not a groundwater source (bgs = below ground surface) REPORT BY SOURCE: If you are permitted for more than one source (for example, a pond is one source, a well is one source, and wells tapping different aquifers are different sources) then separate water use reports are required for each source. Copy the next page if you need another report form. Verify that the report you are completing is for the correct year. You are reporting historical usage. Check the appropriate box for if you are reporting in either GALLONS or ACRE/FEET. METER READING. Record monthly usage for each month you pumped water, NOT the meter reading. ACRE/FEET: Multiply the number of acres irrigated by the number of inches of water applied. Divide by 12 to obtain acre/feet. If your permit is in AFY (acre-feet per year) and you can only report in gallons, we will convert to AFY for you. GALLONS: When reporting GALLONS, use all the zeros and insert the commas. Multiply the system’s operating capacity in gallons per minute by the number of hours the system is run. Multiply that result by 60 to obtain total gallons. DO NOT REPORT your meter reading. Look at your meter. It may be reading x10 or x100 or x1000. For example, if you report: o 2.266 we will record 2 gallons o 22660000 we will record 22,660,000 gallons o REPORT ALL SIGNIFICANT (TRAILING) ZEROS and INSERT COMMAS Total your numbers and record them in the “TOTAL” row. Please verify that your math is correct. Report ZERO if no usage.